Exhibit F - Financial and Orginizational Capacity 03.07.2024.docx
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- Attached to
- Re-Solicitation Texas Farmer Mental Health and Suicide Prevention Helpline and Educational Services
- Solicitation number
- 5510001033
- Issued by
- Texas
About this file
This document is Exhibit F: Financial and Organizational Capacity, a qualification form issued by the Texas Department of Agriculture for vendors responding to the Re-Solicitation Texas Farmer Mental Health and Suicide Prevention Helpline and Educational Services contract opportunity. The exhibit serves as a financial and organizational assessment tool requiring respondents to attest to their fiscal responsibility and operational capacity to perform under state contract terms.
The form requires respondents to disclose any tax filing or payment failures within the past three years, unsatisfactory government performance assessments or liquidated damages exceeding $25,000 within the past five years, and any liens, judgments, or bankruptcy proceedings within the past seven years. Additionally, respondents must confirm they possess sufficient financial resources to perform contracted obligations despite the state's standard payment process, which allows up to 30 days after invoice receipt for payment, with earlier payment contingent only upon early payment discounts. The respondent must provide a signed attestation confirming the accuracy and completeness of all information provided, including printed name and company represented. This exhibit functions as a mandatory compliance and qualification checkpoint in the vendor selection process.
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Text version
Texas Department of Agriculture – Exhibit F Exhibit F
FINANCIAL AND ORGANIZATIONAL CAPACITY
UNDER ANY NAME OR BUSINESS ENTITY:
A. During the past three (3) years, has the Respondent failed to file or pay any tax returns required by federal, state, or local tax laws?
|_| No |_| Yes, with explanation:
B. Within the past five (5) years, has the Respondent
1) Received any formal unsatisfactory performance assessment(s) from any government entity on any contract?
|_| No |_| Yes, with explanation:
2) Had any liquidated damages assessed over $25,000?
|_| No |_| Yes, with explanation:
3) Had any liens or judgments over $25,000 filed against the company, other than UCC filings, which have not been discharged?
|_| No |_| Yes, with explanation:
C. In the last seven (7) years, has the Respondent initiated or been the subject of any bankruptcy proceedings, or is any bankruptcy proceeding pending?
|_| No |_| Yes, with explanation:
D. The State of Texas regulates the timing of payments. Payment cannot be made before goods are received or services rendered and have been accepted. The State has 30 days after receipt of a correct invoice to make payment. Earlier payment is contingent upon offering an early pay discount. Does the Respondent have sufficient resources available to perform as contracted notwithstanding the state’s payment process?
|_| Yes
SIGNATURE AND DATE
I hereby attest that all information provided is complete and accurate to the best of my knowledge.
| Vendor Signature |
| Date |
| Printed Name |
| Company Represented |
|_| No, with explanation:
Exhibit F – 03/07/2024 Page 2 of 2
File details come from the government source that posted it. Updated .